Medicare & Medicaid Coverage for Hearing Care: Your Complete Guide

Navigate public insurance options, understand eligibility, and learn what's covered—and what's not—for hearing aids, cochlear implants, and audiological services.

You're sitting at your kitchen table, trying to make sense of the Medicare handbook that arrived in the mail. Your audiologist said you need hearing aids—both ears, $5,000 total—and you're on a fixed income. You remember hearing somewhere that "Medicare covers hearing aids," but now you're reading page after page about Parts A, B, C, D, and nothing seems to mention hearing aids at all. Your spouse suggests trying Medicaid, but you're not sure if you'd even qualify, or if that's different from Medicare, or if you'd need to choose between them.

This confusion is incredibly common. Medicare and Medicaid are two of the most misunderstood aspects of hearing healthcare coverage, and the stakes feel especially high when you're facing thousands of dollars in out-of-pocket costs. The truth is more nuanced than "Medicare covers hearing aids" or "it doesn't"—and understanding exactly what's available through public insurance programs could mean the difference between affording the hearing care you need or going without.

Here's what you actually need to know about navigating Medicare and Medicaid for hearing healthcare, including the surprising coverage options many people don't realize exist.

Understanding Medicare: The Basics

Medicare is federal health insurance primarily for people age 65 and older, though it also covers some younger people with disabilities. As of 2025, approximately 62.8 million Americans are enrolled in Medicare. But Medicare isn't a single program—it's divided into parts that cover different services, and this is where the confusion about hearing coverage begins.

Original Medicare (Parts A & B): What's Not Covered

Let's address the most common misconception right away: Original Medicare (Parts A and B) does not cover hearing aids or hearing aid fittings. This surprises many people because Medicare covers so many other healthcare services, but hearing aids are explicitly excluded from coverage under federal law.

Here's what Original Medicare does cover related to hearing:

• Diagnostic hearing exams: When ordered by your doctor to determine if you need medical treatment (not for routine hearing screenings or to fit hearing aids)
• Cochlear implants: The surgery, device, and mapping sessions when medically necessary for severe-to-profound hearing loss
• Bone-anchored hearing aids (BAHA): When used to treat specific medical conditions like chronic ear infections or congenital malformations
• Treatment for ear infections, injuries, or diseases: Medical care for conditions affecting your hearing

Medicare Advantage (Part C): Where Coverage Exists

Here's where things get more hopeful: Medicare Advantage plans (also called Part C) are private insurance plans that contract with Medicare to provide all your Part A and Part B benefits, plus often additional coverage that Original Medicare doesn't include—like hearing aids.

As of 2025:

• 34.1 million people are enrolled in Medicare Advantage (54% of all Medicare beneficiaries)
• 97% of Medicare Advantage plans offer some level of hearing benefits
• This means approximately 33 million Americans have potential access to hearing aid coverage through their Medicare Advantage plan

But—and this is important—"some level of hearing benefits" varies dramatically from plan to plan. Coverage typically includes:

What Medicare Advantage Plans Usually Cover:

• Routine hearing exams: Annual or biennial screenings (not just diagnostic tests)
• Hearing aid allowances: Ranging from $500 to $2,500+ per ear
• Fitting appointments: Professional services to adjust and program your devices
• Follow-up care: Adjustments, reprogramming, and check-ins

What Varies Significantly by Plan:

• Coverage amount: Some plans offer $500 per ear every 3 years; others offer $2,500+ per ear annually
• Frequency: Every 1, 2, or 3 years depending on the plan
• Provider networks: Some require you to use specific audiologists or hearing aid vendors
• Device limitations: Some plans limit which technology levels or brands are covered
• Copayments: You may still have copays for exams or devices

How to Check Your Medicare Advantage Hearing Benefits

If you're currently enrolled in a Medicare Advantage plan or shopping for one during open enrollment (October 15 - December 7 each year), here's how to find out what hearing coverage you have:

1. Visit Medicare.gov: Go to the official Medicare Plan Finder tool at medicare.gov/plan-compare
2. Enter your ZIP code: Plans and their benefits vary by location
3. Filter by "Hearing Services": Look for plans that specifically list hearing aid coverage
4. Compare the details:
   • Monthly premiums (many Medicare Advantage plans have $0 premiums)
   • Maximum hearing aid allowances
   • How often benefits renew
   • Whether your current audiologist is in-network
5. Read the Evidence of Coverage (EOC): This detailed plan document explains exactly what's covered and any limitations

Understanding Medicaid: State-by-State Differences

While Medicare is a federal program with consistent rules across the country, Medicaid is a joint federal-state program, which means coverage varies significantly depending on where you live. As of June 2025, 77.7 million Americans are enrolled in Medicaid or CHIP (Children's Health Insurance Program).

Medicaid Hearing Aid Coverage: The State Landscape

Here's what makes Medicaid complex for hearing healthcare:

• Children under 21: Federal law requires all states to cover hearing aids for children enrolled in Medicaid (Early and Periodic Screening, Diagnostic, and Treatment benefit)
• Adults 21 and older: Coverage is optional, and states make their own decisions

What this means in practice: If you live in California or Rhode Island and qualify for Medicaid, you have access to hearing aid coverage. If you live in Nevada, you likely don't—at least not through traditional Medicaid.

Medicaid Eligibility: Who Qualifies

Medicaid eligibility depends on several factors, and recent policy changes have affected who can enroll:

Income Requirements:

• Medicaid Expansion states (39 states + DC): Adults with incomes up to 138% of Federal Poverty Level (FPL)
  • For 2025: ~$20,783 for an individual; ~$42,660 for a family of four
• Non-expansion states: Requirements vary, often much more restrictive (sometimes only covering parents with incomes below 50% FPL)
• People receiving SSI (Supplemental Security Income): Automatically eligible in most states

Asset Requirements:

• Most states: $2,000 for individuals, $3,000 for couples
• Your home, one vehicle, and personal belongings typically don't count toward this limit

How to Apply for Medicaid

The application process varies by state, but generally follows these steps:

1. Check if you qualify: Use your state's Medicaid website or Healthcare.gov to screen for eligibility
2. Gather required documents:
   • Proof of identity (driver's license, birth certificate)
   • Social Security number
   • Proof of income (pay stubs, tax returns, Social Security statements)
   • Bank statements
   • Proof of residency
3. Submit your application:
   • Online: Healthcare.gov or your state's Medicaid website
   • By phone: Contact your state's Medicaid office
   • In person: Visit your local Department of Social Services
4. Wait for determination: Processing typically takes 45-90 days
5. If approved: You'll receive a Medicaid card and information about your benefits
6. If denied: You have the right to request a fair hearing (usually within 30-90 days of denial)

Dual Eligibility: Medicare + Medicaid Together

Approximately 12 million Americans are "dually eligible"—they qualify for both Medicare and Medicaid simultaneously. This is one of the most valuable coverage scenarios for hearing healthcare, though it's also one of the most confusing to navigate.

Who Qualifies for Dual Eligibility?

You may be dually eligible if you:

• Are enrolled in Medicare (age 65+ or younger with disabilities)
• Have low income and limited assets meeting your state's Medicaid requirements
• Receive Supplemental Security Income (SSI)

How Dual Eligibility Works for Hearing Care

When you have both Medicare and Medicaid:

1. Medicare pays first for any services it covers (like cochlear implants or diagnostic exams)
2. Medicaid pays second and can cover:
   • Medicare premiums, deductibles, and copayments
   • Services Medicare doesn't cover—including hearing aids in states that offer adult Medicaid hearing aid coverage

This means if you live in a state with Medicaid adult hearing aid coverage and you're dually eligible, you may have access to hearing aids even though Original Medicare doesn't cover them.

Medicare Savings Programs (MSPs)

Even if you don't qualify for full Medicaid benefits, you might qualify for Medicare Savings Programs, which help pay Medicare costs:

Comparing Your Options: A Side-by-Side Look

What About Private Insurance?

If you're under 65 and have private health insurance through an employer or the Health Insurance Marketplace, hearing aid coverage depends entirely on your specific plan. Unfortunately:

• 73% of hearing aid users have no insurance coverage for their devices
• Only 6% are fully covered
• 25% receive some insurance help, with average payouts around $1,257 per hearing aid

Some states mandate that insurance companies cover hearing aids for children, and a handful require adult coverage, but many private plans exclude hearing aids as "elective" devices.

Common Questions About Medicare & Medicaid Coverage